Association of sepsis-induced cardiomyopathy and mortality: a systematic review and meta-analysis

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Title:	Association of sepsis-induced cardiomyopathy and mortality: a systematic review and meta-analysis
Authors:	Lin, Yu-Min Lee, Mei-Chuan Toh, Han Siong Chang, Wei-Ting Chen, Sih-Yao Kuo, Fang-Hsiu Tang, Hsin-Ju Hua, Yi-Ming Wei, Dongmei Melgarejo, Jesus Zhang, Zhen-Yu Liao, Chia-Te
Contributors:	Chi Mei Hospital Chi Mei Hospital National Cheng Kung University Chi Mei Hospital National Cheng Kung University Department of Health and Nutrition, Chia Nan University of Pharmacy & Science Southern Taiwan University of Science & Technology Chang Gung University of Science & Technology KU Leuven
Keywords:	ventricular systolic dysfunction septic shock diastolic dysfunction myocardial dysfunction ejection fraction performance outcomes
Date:	2022
Issue Date:	2023-12-11 13:56:26 (UTC+8)
Publisher:	SPRINGER
Abstract:	Background: The implication of sepsis-induced cardiomyopathy (SIC) to prognosis is controversial, and its association with mortality at different stages remains unclear. We conducted a systematic review and meta-analysis to understand the association between SIC and mortality in septic patients. Methods: We searched and appraised observational studies regarding the mortality related to SIC among septic patients in PubMed and Embase from inception until 8 July 2021. Outcomes comprised in-hospital and 1-month mortality. We adopted the random-effects model to examine the mortality risk ratio in patients with and without SIC. Meta-regression, subgroup, and sensitivity analyses were applied to examine the outcome's heterogeneity. Results: Our results, including 20 studies and 4,410 septic patients, demonstrated that SIC was non-statistically associated with increased in-hospital mortality, compared to non-SIC (RR 1.28, [0.96-1.71]; p = 0.09), but the association was statistically significant in patients with the hospital stay lengths longer than 10 days (RR 1.40, [1.02-1.93]; p = 0.04). Besides, SIC was significantly associated with a higher risk of 1-month mortality (RR 1.47, [1.17-1.86]; p < 0.01). Among SIC patients, right ventricular dysfunction was significantly associated with increased 1-month mortality (RR 1.72, [1.27-2.34]; p < 0.01), while left ventricular dysfunction was not (RR 1.33, [0.87-2.02]; p = 0.18). Conclusions: With higher in-hospital mortality in those hospitalized longer than 10 days and 1-month mortality, our findings imply that SIC might continue influencing the host's system even after recovery from cardiomyopathy. Besides, right ventricular dysfunction might play a crucial role in SIC-related mortality, and timely biventricular assessment is vital in managing septic patients.
Relation:	ANNALS OF INTENSIVE CARE, v.12, n.CB2, pp.CC2, pp.-2737,
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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